Researchers in Norway found symptoms of depression and anxiety to be significantly higher among people with MS compared with those without MS. This study provides important data on the occurrence of emotional changes in people with MS, and the necessity to increase treatment of these symptoms. Antonie G. Beiske, MD (University Hospital, Akershus, NO) and colleagues report their findings in the European Journal of Neurology (2008 Mar;15(3):239-45). This work was funded by the Norwegian MS Society, the Hølands legacy, the Per B. Larsens legacy, the Kjell Alames Legacy and the Bergen MS Society.
Emotional changes are very common in MS, both as a reaction to the stress of living with a chronic, unpredictable illness and because of neurologic changes caused by the disease. Severe depression, mood swings, irritability, and episodes of uncontrollable laughing and crying pose significant challenges for people with MS and their family members.
Dr. Beiske's team studied depression and anxiety in people with MS in four municipalities in Eastern Norway. They were able to collect and analyze data on 140 patients who underwent clinical and neuropsychiatric examinations. Patients were excluded if they had severe cognitive or psychiatric impairment or a serious medical condition other than MS that would preclude participation. The data were compared with the results of a 2001 study of general and mental health in Norway. Clinical measures used included the HSCL-25, a short, simple checklist of symptoms of anxiety and depression. In the group with MS, fatigue was assessed as well. Participants with MS were asked if they had obtained treatment from a psychiatrist or psychologist, or if they felt an unmet need for treatment of anxiety or depression.
A total of 31.4% of people with MS reported symptoms of depression, significantly higher than the 16.1% reported in the general population; 19.3% of people with MS had anxiety, significantly higher than the 10.9% among controls.
In the group with MS, fatigue and younger age at onset were significantly associated with symptoms of depression. Symptoms of anxiety were associated with fatigue and pain, less disease activity and younger age at onset. Compared to those without fatigue, those with fatigue were almost four times as likely to have depressive symptoms and more than five times as likely to have symptoms of anxiety. In addition, individuals with pain were more than four times as likely to have symptoms of anxiety. Only 15.9% reported having undergone treatment for depression and 11.1% for anxiety. Of untreated people who reported having these symptoms, 18.2% expressed the need for treatment.
"Symptoms of depression and anxiety both independently and in interaction with other MS symptoms affect patients' functioning," write the authors. "Thus, depressive and anxiety symptoms have to be identified and treated, and not interpreted as a natural and inevitable consequence of the disease course."
Learn more about emotional changes that affect people with MS, and about the treatments that are available to relieve these symptoms.
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